Reducing Hypertension among African American Men: A Mobile Stress Management Intervention to Address Health Disparities

减少非裔美国男性的高血压：解决健康差异的移动压力管理干预措施

基本信息

批准号：
10384110
负责人：
Samantha L. Leaf
金额：
$ 25.75万
依托单位：
ISA ASSOCIATES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-18 至 2022-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10384110
关键词：
Address Adherence African American Alcohol consumption Antihypertensive Agents Area Attention Behavior Behavioral Biological Blood Pressure Car Phone Cardiovascular Diseases Cellular Phone Chronic Cognition Cognitive Coping Behavior Coping Skills Development Diabetes Mellitus Diagnosis Diastolic blood pressure Discrimination Emotions Enrollment Etiology Familiarity Feedback Focus Groups Frequencies Gender Goals HIV Homicide Hyperphagia Hypertension Individual Internet Intervention Knowledge Learning Libraries Life Expectancy Life Experience Link Measures Medical Minority Groups Participant Pharmaceutical Preparations Phase Physical activity Physiological Privacy Relaxation Techniques Research Resources Security Series Shapes Smoking Source Stress Stress and Coping Stroke System Testing Text Messaging Thinking Touch sensation Training United States Work allostatic load base behavioral health black men blood pressure intervention blood pressure reduction blood pressure regulation cardiovascular risk factor coping coping mechanism cost cost effective design experience health disparity hypertension control improved mHealth medication compliance men mindfulness mindfulness meditation mobile computing modifiable risk mortality non-compliance peer preference programs prototype psychologic racial discrimination racial disparity recruit response skills stress management stressor substance use text messaging intervention theories therapy design usability web-based assessment

项目摘要

PROJECT SUMMARY/ABSTRACT African American men have the highest rate of hypertension (HTN) in the United States. Once diagnosed, they are also less likely than other groups to achieve blood pressure (BP) control. This health disparity is critical, as elevated BP is the primary modifiable risk factor for cardiovascular disease. One reason for this HTN disparity: stress. African Americans experience more stress than their White peers, most notably from racial discrimination, and have fewer resources to manage these stressors. This stress has significant physiological consequences. Compared to Whites, African Americans show heightened allostatic load, a measure of the biological effects of chronically activating the stress physiological systems. Importantly, stress-induced activation of these systems is implicated in the etiology of HTN. Stress also exacerbates HTN through unhealthy coping (e.g., smoking, overeating, alcohol use) and poorer adherence to antihypertensive medications. Stress predicts these coping behaviors and medical noncompliance in African Americans. Despite clear links between stress and HTN, stress management is not regularly deployed to manage BP. This is a missed opportunity because stress management interventions have been shown to improve HTN. Existing research on stress management interventions for BP reduction included mostly White participants. This is significant because behavioral health programs designed specifically for minority groups are more effective than generic programs. Because stress significantly drives health disparities in HTN, developing effective stress management programs for African American men is vital to closing this gap. One cost-effective, easily scalable solution is mHealth. One of the most accessible mobile formats is text messaging. Importantly, 98% of African Americans own a mobile phone. Most are smartphones (70%). To our knowledge, no mobile cognitive behavioral stress management intervention has been developed for African American men to manage racial and nonracial sources of stress in an effort to reduce HTN disparities. We intend to fill this void. When completed, educational text messages will increase knowledge, develop skills, and reduce barriers to adaptive coping. Supportive texts will affirm the life experiences of African American men. A library of individually tailored videos will be delivered to each user depending on a theory-based assessment of stress (including perceived discrimination) and coping. All mobile web content will be effortlessly and efficiently accessed via touch-based links embedded within text messages. Eighteen African American men will be recruited for focus group discussions to inform prototype development. When the prototype is completed, these 18 target end-users will return for usability testing. The usability test will include a series of tasks intended to highlight the different features of the proposed intervention. Three usability metrics will be assessed: efficiency, accuracy, and acceptability.

项目摘要/摘要在美国，非裔美国人的高血压率最高（HTN）。一旦被诊断出，与其他群体相比，他们也没有可能获得血压（BP）对照。这种健康差异是至关重要的是，由于BP升高是心血管疾病的主要可修改风险因素。这种HTN差异的原因之一：压力。非裔美国人比白人更加压力同龄人，最著名的是来自种族歧视，而管理这些压力源的资源较少。这种压力具有重大的生理后果。与白人相比，非裔美国人表现出更高的同性恋负载，一种衡量慢性激活应力生理系统的生物学作用的量度。重要的是，应力诱导的这些系统的激活与HTN的病因有关。压力也加剧了htn 通过不健康的应对（例如吸烟，暴饮暴食，饮酒）和对降压的依从性较差药物。压力预测了这些应对行为和非裔美国人的医学违规行为。尽管压力与HTN之间的明确联系，不定期部署压力管理来管理BP。这是一个错过的机会是因为已显示压力管理干预措施可以改善HTN。现有关于减少BP的压力管理干预措施的研究主要包括白色参与者。这很重要，因为行为健康计划专门为少数群体设计比通用程序更有效。因为压力显着推动了HTN的健康差异，所以为非裔美国人制定有效的压力管理计划对于缩小这一差距至关重要。一种具有成本效益，易于扩展的解决方案是MHealth。最容易访问的移动格式之一是文本消息传递。重要的是，有98％的非裔美国人拥有手机。大多数是智能手机（70％）。据我们所知，尚未开发出移动认知行为压力管理干预措施非洲裔美国人管理种族和非种族压力来源，以减少HTN差异。我们打算填补这个空白。完成后，教育短信将增加知识，发展技能，并减少自适应应对的障碍。支持文本将肯定非裔美国人的生活经历男人。根据基于理论的不同评估压力（包括感知的歧视）和应对。所有移动网络内容将是通过嵌入文本消息中的基于触摸的链接轻松有效地访问。将招募18名非裔美国人参加焦点小组讨论，以告知原型发展。原型完成后，这18个目标最终用户将返回可用性测试。这可用性测试将包括一系列旨在突出提议的不同功能的任务干涉。将评估三个可用性指标：效率，准确性和可接受性。